甲状腺滤泡状癌淋巴结N_0期与淋巴结微转移的相关性研究

The Correlative Study on Lymph Node Micrometastases Detection in N_0 Follicular Carcinoma of Thyroid

目的探讨甲状腺滤泡状癌淋巴结N0期与淋巴结微转移的相关因素。方法83例432枚常规病理检查阴性的颈淋巴结(pN0),其中N115例,颈淋巴结(pN0)76枚;N068例,颈淋巴结(pN0)356枚。选择细胞角蛋白(CK-19)单克隆抗体,应用免疫组化SP法进行检测,确定其微转移情况并与随访资料进行对比分析。结果83例中16例(19.3%)58枚淋巴结有微转移。在微转移患者中9例(9/16)出现局部复发或远处转移,而67例无微转移患者中仅6例(6/67),P<0.001。同时,N1、N0其微转移分别是7例(7/15)和9例(9/68),P<0.01。结论甲状腺滤泡状癌淋巴结微转移与肿瘤复发及转移密切相关。微转移的检测对术后辅助治疗和预后评估具有一定的指导意义。

Objective To evaluate the correlation between N0 follicular carcinoma of thyroid and lymph node micrometastases.Methods 83 patients with 432 negative neck lymph nodes in routine pathological examination（pN0）were analyzed by immunochemical methods to evaluate the lymph node micrometastasis.Of the 83 patients,15 had clinically N1 disease,and 68 had clinically N0 nodes.The immunochemical results were compared with the follow-up data.Results 58 neck lymph nodes in 16 cases（19.3%） had positive lymph node micrometastasis.Of the 16 patients with node micrometastasis,9 developed local recurrence or distant metastasis;whereas only 6 patients had local recurrence or metastasis in the 67 patients without node micrometastasis（P〈0.001）.7 of the 15 patients with clinically N1 disease and 9 of the 68 patients with clinically N0 disease had micrometastasis（P〈0.01）.Conclusion In follicular carcinoma,lymph node micrometastasis is related to the local recurrence and distant organ metastasis.The detection of lymph node micrometastasis could be helpful in postoperative treatment and prognosis evaluation.